MEDICARE: LEW BROWN,PH.D. PSYCHOLOGIST PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	09119-1	NY

General Provider Information

NPI Number	:	1730432394
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEW BROWN,PH.D. PSYCHOLOGIST PLLC

Provider Business Mailing Address
First Line	:	PO BOX 170297
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-0297
Country	:	US
Telephone Number	:	718-834-1646
Fax Number	:

Provider Business Practice Location Address
First Line	:	68 SAINT MARKS PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-1945
Country	:	US
Telephone Number	:	718-834-1646
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. LEWIS MICHAEL BROWN
Credential	:	PH.D.
Telephone Number	:	718-834-1646

Provider Enumeration Date	:	10/19/2012
Last Update Date	:	10/19/2012

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